Liberman L, Dershaw D D, Rosen P P, Morris E A, Abramson A F, Borgen P I
Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Radiology. 1998 Mar;206(3):711-5. doi: 10.1148/radiology.206.3.9494489.
To determine whether complete percutaneous removal of a malignant lesion detected at mammography ensures complete excision of the carcinoma histopathologically.
A retrospective review was performed of 135 lesions in which stereotactic biopsy was performed with a directional, vacuum biopsy instrument and an 11-gauge probe followed by mammography. Carcinoma was diagnosed at stereotactic biopsy in 51 (38%) lesions. In 15 (29%) carcinomas, the lesion seen at mammography was removed at stereotactic biopsy. Surgical findings were available for correlation with biopsy and imaging findings in all 15 cases. Mammographic and histopathologic findings were reviewed.
Mammographic findings were calcifications in 11 lesions and a mass in four lesions. The median lesion size was 0.7 cm (range, 0.2-1.4 cm), and the median number of biopsy specimens was 15 (range, 10-22 specimens). Histopathologic findings at stereotactic biopsy were ductal carcinoma in situ in 12 lesions and infiltrating ductal carcinoma in three. Surgery revealed residual carcinoma in 11 (73%) of 15 lesions, including all three infiltrating ductal carcinomas and eight of 12 ductal carcinoma in situ lesions.
Complete removal of the mammographic lesion does not ensure complete excision of the carcinoma.
确定乳腺钼靶检查发现的恶性病变经皮完全切除是否能确保在组织病理学上完全切除癌灶。
回顾性分析135个病变，这些病变均使用定向真空活检器械及11号探头进行立体定向活检，随后进行乳腺钼靶检查。立体定向活检诊断为癌的病变有51个（38%）。在15个（29%）癌灶中，乳腺钼靶检查所见病变在立体定向活检时被切除。所有15例均有手术结果可与活检及影像学结果进行对照。对乳腺钼靶及组织病理学结果进行了回顾。
乳腺钼靶检查结果显示，11个病变为钙化，4个病变为肿块。病变大小中位数为0.7 cm（范围0.2 - 1.4 cm），活检标本数量中位数为15个（范围10 - 22个标本）。立体定向活检的组织病理学结果显示，12个病变为导管原位癌，3个为浸润性导管癌。手术发现15个病变中有11个（73%）存在残留癌，包括所有3个浸润性导管癌及12个导管原位癌病变中的8个。
乳腺钼靶检查病变的完全切除并不能确保癌灶的完全切除。
